Completed Research

Appalachian Experiential Learning and Simulation Program (APP-ELS Program)

Funding Agency: Health Resources and Services Administration

Key Personnel: Saundra Regan, PhD; Jackie Knapke, PhD

The App-ELS program leverages distance learning technologies and experiential learning, including simulation, to prepare nursing students to lead coordinated care for vulnerable, at-risk, medically underserved populations impacted by opioid use disorder (OUD). The students completed coursework, experiential case simulations, and rural health nursing experiences as part of the program. App-ELS is a two-year grant project funded by HRSA; Drs. Regan and Knapke serve as evaluators. The project started its second year this fall.

For further information, contact Dr. Jackie Knapke at jackie.knapke@uc.edu.

Primary Care Training Enhancement: Primary Care Champions 

Funding Agency: Health Resources and Services Administration

Key Personnel: Patrick Cafferty, MPA; Jeffery Schlaudecker, MD; Daniel Hargraves, MSW; Megan Rich, MD 

This 5-year HRSA project trains community providers each year from PBRN sites such as Crossroad Health Center. Each provider completes a fellowship program that includes a community-partnered project at their practice site. They receive training in six content areas including physician wellness, mental health, medication-assisted treatment for opioids, medical education, and social determinants of health and quality improvement in their practices.

The fellowship has graduated 14 participants in the first two years (9 physicians, 5 physician assistants), and 5 participants in year three, in August 2021 (3 physicians and 2 physician assistants). Two physicians and one physician assistant are on track to graduate in 2022, as the fourth year of the fellowship. The faculty team has had accepted four abstracts for presentation based on three completed years of evaluation data from content areas of substance use disorder treatment, instructional design theory, and the needs assessment results that also includes a one-year post-graduation follow-up. Statistical significance has been found in knowledge and comfort across all content areas for all cohorts of fellows.

The team recently began interviewing fellow graduates, guest speakers and faculty regarding perceived changes in value to learning and engagement since transitioning from an in-person fellowship to remote experience.

Also, recruitment has begun for the 5th and final year of the fellowship. As of February 2022, four fellows (2 physicians and 2 physician assistants) have committed to the fellowship’s year 5 beginning September 2022

For further information, please contact Dan Hargraves at daniel.hargraves@uc.edu.

EMPOWER: Evaluating the ability to reduce Morphine equivalent dose for chronic pain patients receiving opioid-therapy through a web-based e-health self-management program: a randomized multi-site clinical trial in primary care

Key Personnel: John Winhusen, PhD; Chris White, MD, JD, MHA; Rowena Dolor, MD; Mary Beth Vonder Meulen, RN, CCRC

This project was a 4-year randomized controlled trial of an online patient self-management tool for chronic pain, compared to usual care in patients on chronic opioids for chronic pain. Patients were recruited from two Practice Based Research Networks: the Cincinnati Area Research and Improvement Group (CARInG) at the University of Cincinnati and the Primary Care Research Consortium (PCRC) at Duke University.

The primary outcomes were:

• A decrease in daily MED of opioid medications
• A decrease in the patients’ daily pain scores.

For further information, please view Opioid Dose and Pain Effects Article or contact Mary Beth Vonder Meulen marybeth.vondermeulen@uc.edu

Cognitive Behavioral Therapy for Insomnia (CBT-I) with Black Prenatal Patients

Key Personnel: Montiel Rosenthal, MD (PI), Saundra Regan, PhD, Harini Pallerla, MS, & Keesha Goodnow, BAE (Program Manager)

This project is aimed at decreasing levels of insomnia, stress, and depression; and improving the resilience and overall mental health of pregnant Black Women. This is an evidence proven approach, in group and individual therapy, which reduces insomnia, and depression. Addressing or preventing depression is known to reduce the risk of preterm birth, as well as postpartum depression. The grant provides support for Family Medicine residents, nurses, APNs and faculty physicians to complete CBT-I training. The goal is to provide CBT-I to 90 patients over 2 years  (up to five sessions per patient), as well as expand the competency of care providers at two sites.  This will allow for further expansion of CBT-I into traditional prenatal care. 

For further information, please contact: Harini Pallerla harini.pallerla@uc.edu

Primary Care Training Enhancement: Primary Care Champions

Key Personnel: Patrick Cafferty, MPA; Jeffery Schlaudecker, MD; Daniel Hargraves, MSW; Megan Rich, MD, MEd

This 5-year HRSA project trains community providers each year from PBRN sites such as Crossroad Health Center. Each provider completes a fellowship program that includes a community-partnered project at their practice site. They receive training in six content areas including physician wellness, mental health, medication-assisted treatment for opioids, medical education, and social determinants of health and quality improvement in their practices.

The fellowship has graduated 14 participants in the first two years (9 physicians, 5 physician assistants), and 5 participants in year three, in August 2021 (3 physicians and 2 physician assistants). Two physicians and one physician assistant are on track to graduate in 2022, as the fourth year of the fellowship. The faculty team has had accepted four abstracts for presentation based on three completed years of evaluation data from content areas of substance use disorder treatment, instructional design theory, and the needs assessment results that also includes a one-year post-graduation follow-up. Statistical significance has been found in knowledge and comfort across all content areas for all cohorts of fellows.

The team recently began interviewing fellow graduates, guest speakers and faculty regarding perceived changes in value to learning and engagement since transitioning from an in-person fellowship to remote experience.

For further information, please view Transition of a Primary Care Fellowship Article, watch Promoting Provider Wellness Video Conference or contact Dan Hargraves at daniel.hargraves@uc.edu.

Related Posters: view NCEAS 2019 SDH Poster, OAPA Conference 2019 Poster, PAEA 2020 Poster, STFM 2020 Annual Conference CPCC Fellowship Poster, STFM 2021 CPI Fellowship Poster, and 2021 CPCC Research Poster.

Introducing an Intellectual and Developmental Disability Curriculum for Medical Students at the University of Cincinnati College of Medicine (NCIDM: National Curriculum Initiative in Developmental Medicine)

Key Personnel: Lauren Wang, MD; Harini Pallerla, MS

This study aims to make meaningful enhancements to the UC COM curriculum as it pertains to educating future physicians about patients with intellectual and developmental disabilities. Data collection is complete, including knowledge and attitude surveys from before and after the curriculum enhancements. Analysis of this data is now in progress. 

For further information, please contact Harini Pallerla at harini.pallerla@uc.edu

ECHO Telementoring for Chronic Pain

Key Personnel: Susie McDonald, MS

The aim of this program is to diffuse knowledge and amplify the capacity to provide best practice care for underserved people across the region through Project ECHO (Extension for Community Healthcare Outcomes) telementoring clinics on chronic pain, epilepsy/neurology, and medication assisted treatment.

For further information, please visit www.cincinnatiecho.com or contact Andi Christopher at chrisao@ucmail.uc.edu.

Cardi-OH Diabetes Quality Improvement Project 

Key Personnel: Manoj Singh, MD; Mary Beth Vonder Meulen, RN 

This Quality Improvement Project is statewide initiative of the Ohio Cardiovascular Health Collaborative and Ohio Medicaid. The University of Cincinnati, under the leadership of Case Western Reserve University, is midway through this QIP which is focused on improving outcomes for adult Medicaid patients with uncontrolled Diabetes (HbA1c>9%). The UCH-PC Quality Improvement Team is working with experts from the Institute for Healthcare Improvement (IHI).

Three of the UCH-PC practices have been running diabetic care improvement cycles (PDSA cycles) in the areas of pharmacy, mental health, and the use of Care Managers to support the clinical teams. After the first six months of trialing these interventions, practice providers found that when a Care Manager was added to the clinical team, improvements in HbA1c levels were noted.

For further information, please contact Mary Beth Vonder Meulen RN at vondermb@ucmail.uc.edu.

Primary Care Training and Enhancement (PCTE) MAT Supplemental

Key Personnel: Jeffery Schlaudecker, MD; Daniel Hargraves, MSW;

The Primary Care Training and Enhancement (PCTE) MAT Supplemental, led by Dr. Jeffrey Schlaudecker and Daniel Hargraves, and funded by Health Resources and Services Administration, aimed to strengthen the primary care workforce by supporting enhanced training for future primary care clinicians, teachers and researchers and promoting primary care practice in rural and underserved areas. Family Medicine residents and faculty physicians along with community healthcare professionals will gain knowledge and confidence in identifying and treating opioid use and other substance disorder with Medication Assisted Treatment (MAT) through discreet activities that provide, discussion of challenges and facilitators, hands-on experiences and direct exposure to treatment methods. The goal is to increase the number of MAT providers in our region to mitigate the toll of the opioid epidemic. 

For further information, please view PCTE MAT article or contact Dan Hargraves at daniel.hargraves@uc.edu.

Randomized Control Trial of an Over-the-Counter Homeopathic Rubbing Oil vs. Placebo Rubbing Oil for Immediate Relief of Leg and Foot Neuropathy Pain

Key Personnel: Harini Pallerla, MS; Mary Beth Vonder Meulen, RN

The aim of this research funded by Wise Consumer Products Company was to study whether a currently available over-the-counter homeopathic Neuropathy Rubbing Oil Product produces superior pain relief compared to placebo in patients with peripheral neuropathy on the legs and/or feet as measured by a modified Neuropathy Pain Scale (NPS). 

For further information, contact Harini Pallerla at harini.pallerla@uc.edu

Evaluation of Community Screenings in Primary Care

Key Personnel: Nancy Elder, MD; Christopher White, MD, JD, MHA; Dan Hargraves, MSW

In partnership with Interact for Health, Dr. Nancy Elder, Dr. Christopher White and Dan Hargraves evaluated the reach and success of Interact for Health funded projects supporting Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs in community practices. This four-year evaluation assessed projects screening for a number of important conditions, including drug and alcohol use, tobacco use and depression.

For further information, please view the Public Health Reviews article and All-Ohio SBIRT poster or contact Dan Hargraves at daniel.hargraves@uc.edu.

Improving Mental Health Among Group Visit Prenatal Patients

Key Personnel: Montiel Rosenthal, MD; Saundra Regan, PhD; Harini Pallerla, MS; Mary Beth Vonder Meulen, RN

This project led by Dr. Montiel Rosenthal, Dr. Saundra Regan, Harini Pallerla (MS), and Mary Beth Vonder Meulen (RN),  (funded by CCTST) focused on depression, stress reduction, substance abuse, patient education and empowerment of pregnant women participating in group visits to improve the outcomes of their pregnancies. Presentations to the prenatal groups occurred with sessions on Lactation, Infant CPR, Prenatal Yoga, Safe Sleep for Infants, Substance Abuse in Pregnancy, Meditation and Depression Self-Help Measures. Social Worker referrals for community based maternity and mental health services targeted women at highest risk who scored highest on screening tools. Patient outcomes were analyzed using pre- and post-delivery testing and electronic health record review of mother and baby with respect to gestational age at time of delivery, infant birth weight, # of emergency room/triage visits, tobacco, alcohol and street drug use and cessation, stress and depression scale scores, breastfeeding, and attendance at post-partum visit.

For further information, contact Harini Pallerla at harini.pallerla@uc.edu

Partnerships that Promote Integrated, Multidisciplinary Training Models and Increase Healthcare Access for the Ohio Medicaid Population

Key Personnel: Joseph Kiesler, MD; Daniel Hargraves, MSW;

The major goal of this project, led by Dr. Joseph Kiesler,  Dr. Diana McIntosh, and Daniel Hargraves was to collaborate with the community to develop multidisciplinary approaches to train practitioners to provide integrated primary and mental health care to the underserved. Through multiple educational activities and multiple training sites, this project provided innovative and inter-professional training for residents, students, advanced practice psychiatric mental health nurse practitioners and non-psychiatric providers in caring for Ohio’s Medicaid population.

For further information, please view the MEDAPP ATRN poster and the STFM CPI poster or contact Dan Hargraves at daniel.hargraves@uc.edu.